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Agreement A-17-018 with CDPH.pdf
StateofCalifornia-HealthandHumanServicesAgency-CaliforniaDepartmentofPublicHealthCDPH1229(3/2016)CALIFORNIASEXUALLYTRANSMITTEDDISEASESPROGRAMCoreSTDProgramManagementAwardedByTHECALIFORNIADEPARTMENTOFPUBLICHEALTH,hereinafter“Department”TOCountyofFresno,hereinafter“Grantee”Implementingtheproject“CoreSTDProgramManagement,”hereinafter“Project”GRANTNUMBER16-10713TheDepartmentawardsthisgrantandtheGranteeacceptsandagreestousethegrantfundsasfollows:AUTHORITY:TheDepartmenthasauthoritytograntfundsfortheProjectunderHealthandSafetyCodeSection131085(a).PURPOSE:TheDepartmentshallprovideagranttoandforthebenefitoftheGrantee.TheGranteewillimplementevidence-basedpublichealthactivitiestoproactivelyaddresssexuallytransmitteddiseaseswithinthelocalhealthjurisdiction,withanemphasisonthepreventionandcontrolofinfectioussyphilis,congenitalsyphilis,gonorrhea,andchlamydiatrachomatisinfectionasdescribedandspecifiedintheScopeofWork.GRANTAMOUNT:Themaximumamountpayableunderthisgrantshallnotexceedonehundredfifty-threethousand,sixhundredsixty-sixdollars($153,666).TERMOFGRANT:ThetermoftheGrantshallbeginonJuly1,2016,oruponapprovalofthisgrant,andterminatesonJune30,2019.NofundsmayberequestedorinvoicedforworkperformedorcostsincurredafterJune30,2019.PROJECTREPRESENTATIVES:TheProjectRepresentativesduringthetermofthisgrantwillbe:CaliforniaDepartmentofPublicHealthGrantee:CountyofFresnoName:ChristineJohnsonGrantManagerName:StephanieGarciaSupervisingCommunicableDiseaseSpecialistAddress:P.O.Box997377,MS7320Address;1221FultonMallCity,Zip:Sacramento,CA95899-7377City,Zip:Fresno,CA93721Phone:(916)552-9796Phone:(559)600-3434Fax:(916)440-5361Fax:(559)600-7601Email:Christine.Johnson(®cdoh.ca.aovEmail:steDhanieaarcia(5)co.fresno.ca.usPage1of3 StateofCalifornia-HealthandHumanServicesAgency-CaliforniaDepartmentofPublicHealthCDPH1229(3/2016)Directallinquiriesto:CaliforniaDepartmentofPublicHealthSTDControlBranchGrantee:CountyofFresnoAttention:STDControlBranchName:StephanieGarciaSupervisingCommunicableDiseaseSpecialistAddress:P.O.Box997377,MS7320Address:1221FultonMallCity,Zip:Sacramento,CA95899-7377City,Zip:Fresno,CA93721Phone:(916)552-9796Phone:(559)600-3434Fax:(916)440-5361Fax:(559)600-7601Email:Christine.Johnson(®cdDh.ca.aovEmail:steohanieaarciaSico.fresno.ca.usEitherpartymaychangeitsProjectRepresentativeuponwrittennoticetotheotherparty.STANDARDPROVISIONS.Thefollowingexhibitsareattachedandmadeapartofthisgrantbythisreference:ExhibitASCOPEOFWORKExhibitBBUDGETDETAILANDPAYMENTPROVISIONSExhibitCSTANDARDGRANTCONDITIONSExhibitDADDITIONALPROVISIONSGRANTEEREPRESENTATIONS:TheGrantee(s)acceptallterms,provisions,andconditionsofthisgrant,includingthosestatedintheExhibitsincorporatedbyreferenceabove.TheGrantee(s)shallfulfillallassurancesandcommitmentsmadeintheapplication,declarations,otheraccompanyingdocuments,andwrittencommunications(eg.,e-mail,correspondence)filedinsupportoftherequestforgrantfunding.TheGrantee(s)shallcomplywithandrequireitscontractorsandsubcontractorstocomplywithallapplicablelaws,policies,andregulations.Page2of3 ExhibitAScopeofWorkCountyofFresno16-107131.ServiceOverviewTheGranteewillimplementevidence-basedpublichealthactivitiestoproactivelyaddressSexuallyTransmittedDiseases(STD)withinthelocalhealthjurisdiction.Particularemphasisshouldbeplacedonthepreventionandcontrolofinfectioussyphilis,congenitalsyphilis,gonorrhea(GC),andchlamydiatrachomatis(CT)infection.KeystrategictargetsforSTDpreventionandcontrolare:implementationofcase-basedsurveillance;assuranceoftimelyaccesstoqualityclinicalservices;verificationofappropriateSTDtreatment;investigationofreportedcases,unusualdiseases,oroutbreaks;identificationofaSTDpatient’ssexualandsocialnetworkcontactsandreferralforexaminationand/ortreatmenttopreventfurtherdiseasetransmissionorcomplications;andhealtheducationandhealthpromotionactivitiestopreventSTDsandenhanceawarenessofindividualsatriskforSTD,medicalproviders,andotherserviceproviderswithinthecommunity.Fundingforthegranteesarefromaone-timeFiscalYear2016/2017appropriationwhichcanbeexpendedorencumbereduntilJune30,2019per4265-111-0001,Provision6oftheBudgetAct2016/2017,SenateBill826,Chapter23.2.ServiceLocationTheservicesshallbeperformedatapplicablefacilitiesintheCountyofFresno.3.ServiceHoursTheservicesshallbeprimarilyprovidedMondaythroughFriday,from8:00a.m.to5:00p.m.andincludeevenings,weekends,andholidaysasneeded.Page1of16 ExhibitAScopeofWorkCountyofFresno16-107134.ProjectRepresentativesA.Theprojectrepresentativesduringthetermofthisagreementwillbe:CaliforniaDepartmentofPublicHealthCountyofFresnoMattAysonStephanieGarciaChief,BusinessOperationsSupportSectionSupervisingCommunicableDiseaseSpecialistSTDControlBranchCountyofFresnoTelephone:(916)552-9819Telephone:(559)600-3434Fax:(916)440-5106Fax:(559)600-7601Email:Matt.AvsonOcdDh.ca.aovEmail:steohanieaarcia(5)co.fresno.ca.usB.Directallinquiriesto:CaliforniaDepartmentofPublicHealthCountyofFresnoSTDControlBranchStephanieGarciaAttention:ChristineJohnsonSupervisingCommunicableDiseaseSpecialist1616CapitolAvenue,MS7320CountyofFresnoP.O.Box9973771221FultonMallSacramento,CA95899-7377Fresno,CA93721Telephone:(916)552-9796Telephone:(559)600-3434Fax:(916)440-5361Fax:(559)600-7601Email:Christine.Johnson(a)cdDh.ca.qovEmail:steDhanieaarcia@co.fresno.ca.usC.Eitherpartymaymakechangestotheinformationabovebygivingwrittennoticetotheotherparty.Saidchangesshallnotrequireanamendmenttothisagreement.SubgranteesmustcomplywiththeStateContractingManualVolumeI,3.17.2.D.Page2of16 ExhibitAScopeofWorkCountyofFresno16-107135.ServicestobePerformedParti:CoreSTDProgramManagementGoal:Toprovidelocalassistancefundingtolocalhealthjurisdictions(LHJs)tobuildlocalinfrastructureandworkforcecapacitytoconductSTDsurveillanceandimplementevidence-based,effectiveinterventionstoreducethetransmissionandnegativehealtheffectsofsexuallytransmittedinfections.CoreSTDprogrammanagementisfocusedonthepreventionofCT,GC,andsyphilisthroughhealtheducation;promotionandoutreach;assuranceofqualitylocalSTDclinicalservices:diseaseinvestigation;andpolicydevelopmentandcommunication.TheGranteeisresponsibleforcompletingtheactivitiesthathavebeenselectedbytheplacementofan“X”inthecheckbox.Anumberoftheseactivitiesaremandatoryrequirementsforfunding,indicatedwithan“X.”Otheractivitiesareoptional,baseduponlocalprogramneedandresources.Pleaseindicatewhichoftheseadditionalactivitiesyourlocalhealthjurisdictionwillpursuebyplacingan“X”intheappropriatecheckbox.End-of-YearreportsshouldbesubmittedtoSTDLHJContracts&.cdph.ca.govbyJuly31followingtheendofeachfiscalyearduringthetermofthisgrant.ThereportfortheperiodofJuly1,2016throughJune30,2019willbedueonJune30,2019.ActivitiesPerformanceIndicators/Deliverables•=CDPHwillprovidebiannualreportswithindicatorTimelineI.Assurequalitycase-basedsurveillanceforsyphilis,GC,andCT.[X]A.Adheretoalldatasecuritystandardsandguidelinesinaccordancewithstateandfederalguidance.(Requiredactivity).Datasecuritystandardsandguidelinesareincompliancewithstateandfederalguidance.7/1/16-6/30/19£3B.Providecase-baseddatatotheCaliforniaDepartmentofPublicHealth(CDPH)throughtheuseoftheCaliforniaReportableDiseaseCompletionandclosureofsyphilis,GC,andCTcasesdiagnosedinJanuary-JunebyAugust30ofthat7/1/16-6/30/19InformationExchange(CalREDIE).IfCalREDIEisnotavailable,providecase-baseddatathroughothermeansperagreementbetweenthelocalSTDControlOfficerandtheSTDControlBranch(STDCB)ChiefoftheSurveillanceandEpidemiologyUnit(Requiredactivity).yearinCalREDIE*.Completionandclosureofsyphilis,GC,andCTcasesdiagnosedinJuly-DecemberbyFebruary28ofthatyearinCalREDIE*.Semi-annualcaseclosurePage3of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables*=CDPHwillprovidebiannualreportswithindicatorTimelineIXlC.Assurecompletenessandaccuracyofkeyvariablesthroughlocalreviewofsurveillancereportsandproviderfollow-upofselectGCandearlysyphiliscases.(Requiredactivity).ProportionofGCandearlysyphiliscaseswithcompletedataforthefollowingkeyvariablesinCalREDIE:•TreatmentDate*•MedicationandDosage*•Race/Ethnidty*•PatientAddress*•ProviderNameandAddress*•GenderofSexPartners*•HIVStatus*•PartnerTreatment*7/1/16-6/30/19Proportionoffemalesyphiliscaseswithcompleteprovider-confirmedpregnancystatus*.1X1D.AssureproviderreportingofsyphilisandGCcasesinaccordancewithstateregulations.(Requiredactivity).Casereportingbyproviderswithin14daysofspecimencollectionforsyphilisandGC*.7/1/16-6/30/191X1E.Utilizecase-basedsurveillancedatathrough,ataminimum,routineexaminationofratesandtrendsbyage,gender,race/ethnicity,andotherkeyvariables.(Requiredactivity).DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19XIF.Conductenhancedsurveillanceforallprioritysyphiliscasesusingmedicalrecorddataandcaseinterviewsasnecessary.(Requiredactivity).Completedinterviewrecordsforenhancedsurveillanceonprioritysyphiliscases:•Earlysyphilis*•Congenitalsyphilis*7/1/16-6/30/19Semi-annualcaseclosureCompletionanddosureofcasesasdescribedinI.B.XIG.ConductenhancedsurveillanceonGCcasesaspartofaninvestigationofastrainwithresistanceordecreasedsusceptibilitytoantibiotics.(Requiredactivity).CompletedinterviewrecordsforCA-GISP-assignedGCcases*.CompletionandclosureofcasesasdescribedinI.B.7/1/16-6/30/19Semi-annualcaseclosurePage4of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables•=CDPHwillprovidebiannualreportswithindicatorTimelineIIH.ConductenhancedsurveillanceonGCcasesaspartofanoutbreakorunusualoccurrenceinvestigationand/oraspartofageo-targetedassessmentandintervention.CompletedinterviewrecordsforGCcases*.CompletionandclosureofcasesasdescribedinI.B.7/1/16-6/30/19Semi-annualcaseclosureI|I.ConductenhancedsurveillanceonGCcasesaspartoftheCaliforniaGonorrheaSurveillanceSystem(CGSS2.0).CompletedtimelyandCalREDIE-enteredinterviewrecordsforCGSS-sampledGCcases*.CompletionandclosureofcasesasdescribedinI.B.7/1/16-6/30/19Semi-annualcaseclosureOptionalSOWNarrative:LHJhasneworinnovativetasksthatarenotoartofcurrentSectionIactivities.Describethespecificmethodsandapproachesthatwillbeusedtocompletetheactivitiesselectedforthisobjective.Brieflydescribetheanticipatedscopeoftheproposedactivities,deliverables,andaprojectedtimeline,includingtheapproximatebeginningandendingmonthandyearforeachmajoractivity.Notapplicable.II.ConducthealthpromotionactivitiesforyouthatriskofSTDstoincreaseSTD/sexualhealthawarenessandconductprimaryprevention.CXIA.UtilizeSTDdatatodefinelocalprioritypopulationsand/orgeographicareasfortargetinghealthpromotionefforts,withanemphasisonyouthandunderservedpopulations.(Requiredactivity).DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31IAIB.DescribeexistingcommunityresourcesandidentifypotentialgapsrelatedtoSTDpreventionandeducation.(Requiredactivity).DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31Page5of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables•=CDPHwillprovidebiannualreportswithindicatorTimeline]C.Providetechnicalassistance,training,resources,andreferralstoschooldistrictsandotherschool-basedpartnersondeliverinaaualitvsexualhealtheducationandconfidentialsexualhealthservicesinaccordancewithstateregulations.1DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31||D.Providetechnicalassistanceandtrainingforbuildingcapacityamongyouth-servinqcommunitv-basedorganizationstoensurevouthhaveaccesstomedicallyaccurateinformation,preventiontools,andsexualandreproductivehealthclinicalsen/ices.DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31||E.ActasalocalresourcetoplanandimplementtheCaliforniaYouthRiskBehavioralSurvey(YRBS)inCDC-selectedschools(selectionbyCDCtobedetermined).Examplesofthisincludecontactinglocalschooldistrictstoencourageparticipation,promotingthesurveywithparentandteachergroups,orhavinglocalstafftrainedtoadministerthesurveyinselectedschools.ProportionoflocalschoolsparticipatinginYRBSamongschoolsselectedforYRBS(numberandlocationsvarybetweensurveycycles,whichoccureveryotheryearbeginningin2016.Everyotheryear,beginningin2016.||F.Actasalocalresourceforschooldistricts,partneringwithCDPHontheDivisionofAdolescentSexualHealth(DASH)-fundedactivities.DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31IIG.Supportlocalimplementationandexpansionofstatewidehealthpromotionactivities,suchas:implementingtheMlKnow"project(selectLHJsonly);recruitingnewCondomAccessProject(CAP)sites(minimum3perLHJ;maximumsapply).1DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport,includingthenumberofCAPsitesand,ifapplicable,adescriptionof“IKnow"promotionactivitiesandoutcomes.7/1/16-6/30/19Reportdueannuallyby7/31||H.Promoteweb-basedsexualhealthpromotionprograms(e.g.,HookUp,Teensource.org,TalkWithYourKids.org)withlocalschools,parents,providers,community-basedorganizations,andotherkeystakeholdersservingat-riskpopulations.1DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport,includingmethodsofpromotingresources.7/1/16-6/30/19Reportdueannuallyby7/31Page6of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables*=CDPHwillprovidebiannualreportswithindicatorTimelineII.UtilizeavailablepromotionalmaterialsandoutreachopportunitiesduringSTDAwarenessMonth(April)topromotethenationalGetYourselfTested(GYT)campaign.1DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/17Reportdueannuallyby7/31Optional:PlaceacheckmarkintheboxonlyifGranteeplanstosubcontract.11J.Subcontractwithcommunity-basedorotherorganizationstoensuresuccessofcoreSTDprogramfunctions(checkboxifconductingthisactivity).1Subcontractwithcommunityorotherorganizations,ifneeded.7/1/16-6/30/19OptionalSOWNarrative:LHJhasneworinnovativetasksthatarenotDartofcurrentSectionIIactivities.Describethespecificmethodsandapproachesthatwillbeusedtocompletetheactivitiesselectedforthisobjective.Brieflydescribetheanticipatedscopeoftheproposedactivities,deliverables,andaprojectedtimeline,includingtheapproximatebeginningandendingmonthandyearforeachmajoractivity.Notapplicable.ActivitiesPerformanceIndicators/Deliverables*=CDPHwillprovidebiannualreportswithindicatorTimelineIII.AssurehighqualitySTDscreeningandtreatmentservicesareavailableintheLHJ.EX]A.AssessmajorsourcesofSTDclinicalcareandcharacterizedbypatientcensus,clinictype(referencelisttobeprovidedbySTDCB),andlocationandpopulationservedtoidentifypotentialgapsinaccesstoSTDservices.(Requiredactivity).DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31IiB.Assessqualityofcareamongprovidersinhighvolumeclinicsorservinghighmorbidityareasincludingcompetencyprovidingservicestoyouth;diverseracial/ethnicgroups;andlesbian,gay,bisexual,andtransgender(LGBT)patients,asappropriate.DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.Asapplicable,descriptionof:7/1/16-6/30/19Reportdueannuallyby7/31Page7of16 CountyofFresno16-10713ExhibitAScopeofWorkActivitiesPerformanceIndicators/Deliverables•=CDPHwillprovidebiannualreportswithindicatorTimeline•STDscreeningpractices•AdherencetoSTDtreatmentrecommendations•Culturalcompetencytoserviceat-riskgroups|lC.Workwiththehighestleveloflocalclinicleadershipforpublicandprivateprovidersinthecommunitytoestablishpoliciesrelatedtoclinicalqualityimprovement(Ql)activitiesfocusedonexpandedscreening,diagnosis,andpresumptivetreatment;publichealthreporting;timelyandeffectivemanagement;partnertreatment;andrepeattesting.ProvidetechnicalassistancerelatedtoimplementationofclinicalQlactivities.DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport,includingtoolsandprotocolsthatmaybesharedwithotherLHJs,asapplicable7/1/16-6/30/19Reportdueannuallyby7/31||D.Workwiththehighestleveloflocalclinicleadershipforpublicandprivateprovidersinthecommunity,includingSTDclinicsettings,toestablishpoliciesrelatedtoclinicalQlactivitiesfocusedonHIVscreeningamongsyphilisandgonorrheacases.ProportionofearlysyphiliscaseswithknownHIVstatus(positiveortestednegativewithin30daysofSTDdiagnosis)*.ProportionofGCcaseswithknownHIVstatus(positiveortestednegativewithin30daysofSTDdiagnosis)*.7/1/16-6/30/19Reportdueannuallyby7/31||E.Establishprotocolsandimplementproviderfeedbackmechanismsformanagementofinadequateordelayedtreatment.Developprotocoltomonitorprovidertreatmentpracticesandfortargetinginterventionsatlow-performingproviders.ForGCandearlysyphilis,proportionwithrecommendedtreatmentdocumentedinCalREDIE,andproportionwhoreceivedrecommendedtreatmentwithin7daysandwithin14daysofspecimencollection*.7/1/16-6/30/19||F.Implementpublichealthdetailingprogramstargetedtoprovidersinhighvolumeclinicsorservinghighmorbidityareas(e.g..familyplanningsettings,HIVcareproviders,FederallyQualifiedHealthCenters,school-basedhealthcenters,obstetrics/gynecologyoffices,pediatricoffices,familypracticeandprimarycare,andprenatalcareproviders).DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.Measuresincludetotalnumberofprovidervisits/trainings,numberandtypesofproviders7/1/16-6/30/19Reportdueannuallyby7/31Page8of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables•=CDPHwillprovidebiannualreportswithindicatorTimelineProgramsmayincludetraining,disseminationofresources,andtechnicalassistance.1visited/trained,andnumberandtypesofresourcesdisseminated.||G.MonitorqualityoflocalhealthdepartmentSTDclinicalservicesincludingscreeningrates,treatment,HIVtestingofSTDcases,partnerreferral/treatment,epidemiologictreatmentofDiseaseInterventionSpecialist(DlS)-referredcontacts,andrepeattestingrates.(RequiredactivityforlocalhealthjurisdictionswithhealthdepartmentbasedSTDclinicalservices.)DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.PercentofpatientsdiagnosedwithGCandearlysyphilisinSTDclinicswhoweretestedforHIVwithin30dayspriortoorafterSTDdiagnosis*.Percentofthosetested(above)whoarenewly-diagnosedasHIV-infected*.ProportionofGCcasesthatareretestedin3months.7/1/16-6/30/19Reportdueannuallyby7/31IIH.MonitorqualityoflocalhealthdepartmentSTDclinicalservices,includinglinkagetoHIVcarefornewlyidentifiedpatientswithHIVandre-engagementinHIVcareforthoseoutofcare.DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.Percentofthosenewlydiagnosed(above)whoarelinkedtoHIVcarewithin90daysofthedateofHIVtest*.7/1/16-6/30/19Reportdueannuallyby7/31||LAssessavailabilityofandpromoteorprovidepatient-deliveredpartnertherapy(PDPT)forpatientsdiagnosedwithCT/GC.DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31Optional:PlaceacheckmarkintheboxonlyifGranteeplanstosubcontract.IIJ.Subcontractwithcommunity-basedorotherorganizationstoensuresuccessofcoreSTDprogramfunctions(checkboxifconductingthisactivity)/Subcontractwithcommunityorotherorganizations,ifneeded.7/1/16-6/30/19Page9of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables•sCDPHwillprovidebiannualreportswithindicatorTimelineOptionalSOWNarrative:LHJhasneworinnovativetasksthatarenotDartofcurrentSectionIIIactivities.Describethespecificmethodsandapproachesthatwillbeusedtocompletetheactivitiesselectedforthisobjective.Brieflydescribetheanticipatedscopeoftheproposedactivities,deliverables,andaprojectedtimeline,includingtheapproximatebeginningandendingmonthandyearforeachmajoractivity.Notapplicable.IV.Conductdiseaseinterventionactivities,includingpartnerservices,forprioritySTDstopreventfurthertransmissioninthecommunityorfrommother-to-child.CXIA.Processincomingsyphilisreactorstodetermineprioritizationforpublichealthaction,conductrecordsearching,anddataentry.(Requiredactivity).Mediannumberofdaysbetweenreportandinitiationofreactors,stratifiedbypriorityalertvalue.7/1/16-6/30/19[X]B.Forprioritysyphilisreactors(Alertcodesredandorange):Contactprovidersandpatients,asneeded,toverifydiagnosisandtreatmentandreferuntreatedpatientstocare.Forfemalesofchild-bearingage(ages15-44)withreactiveserologicaltests,determinepregnancystatusandassuretimelyandappropriatetreatment.(Requiredactivity).Proportionofearlysyphiliscases,stratifiedbygender,treatedwithin14daysofspecimencollection*.Proportionoffemalesyphiliscaseswithcompleteprovider-confirmedpregnancystatus*.Proportionofpregnantfemaleswithsyphilistreatedgreaterthan30dayspriortodelivery*.[XIC.ForearlysyphiliscaseswithunknownornegativeFilVstatus:ConductconfirmationofHIVstatusorfacilitationofHIVtestingandlinkageorre¬engagementtocare.(Requiredactivity).ProportionofearlysyphiliscaseswithdocumentedHIVtestwithin30daysbeforeoraftersyphilisdiagnosis*.OfthoseeariysyphiliscasestestedandnewlydiagnosedwithHIVfromabove,proportionwitha7/1/16-6/30/19Page10of16 CountyofFresno16-10713ExhibitAScopeofWorkActivitiesPerformanceIndicators/Deliverables*=CDPHwillprovidebiannualreportswithindicatorTimelineconfirmedHIVcaremedicalvisitwithin90daysofHIVtest*.CXID.ForearlysyphiliscasesthatareHIV-infected:ConfirmengagementinHIVcareorfacilitatere-engagementtocare.(Requiredactivity).Proportionofearlysyphilis/HIVco-infectedcaseswithconfirmationofcurrentHIVmedicalcarevisit*.OfpatientswhoareknowntobeHIV-infectedandareoutofHIVcare,proportionwhoarere-engagedincarethroughconfirmedHIVcaremedicalvisitwithin90daysofSTDdiagnosis*.7/1/16-6/30/19ME.Forallearlysyphiliscases:Conductclientinterviewandcasemanagementincludingcollectionofmedicalinformationandclientriskinformation;riskreductioncounseling;elicitationofsexualandsocialnetworkpartners;andreferralforotherservicesasrelevant.(Requiredactivity).Proportionofearlysyphiliscasesinterviewedwithin14and30daysofspecimencollection*.Proportionofearlysyphiliscasesinterviewedwithatleastonepartnerinitiatedfornotificationofexposure*.7/1/16-6/30/19[XlF.Forpartnersofallearlysyphiliscases:AssuretestingandappropriatetreatmentofsexualandsocialnetworkpartnersincludingnotificationofexposuretosyphilisandHIVandfacilitateSTDandHIVtesting,treatmentandlinkageorre-engagementtoHIVcare,asrelevant.(Requiredactivity).Proportionofinitiatedpartnersofearlysyphiliscasesthatare:•Newlytestedforsyphilis(amonginitiatedpartners)*.•Preventative/prophylactictreatedwithin14daysoftest(amongsyphilistestedabovewithnegativetestandrecentexposure)*.•Newlydiagnosedwithsyphilis(amongsyphilistestedabove)*.•Confirmedsyphilistreatmentwithin14daysofsyphilistest(amongnewlydiagnosedabove)*.•NewlytestedforHIV(amonginitiatedpartners)*.•NewlyidentifiedHIVpositive(amongHIVtestedabove)*.•ConfirmedHIVmedicalcarevisitwithin90daysofHIVtest(amongnewlydiagnosedwithHIV)*.Page11of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables*=CDPHwillprovidebiannualreportswithindicatorTimeline•Re-engagedincarethroughconfirmedHIVcaremedicalvisitwithin90daysofSTDtest/diagnosis(amonginitiatedpartnersknowntobeHIV-infectedandoutofHIVcare)\CX3G.Forearlysyphiliscasesamongfemalesofchild-bearingage(ages15-49):Inadditiontointerviewandcasemanagement,providepartnerservicestoassuretestingandappropriatetreatmentofpartners.(Requiredactivity).Proportionoffemalesyphiliscasesages15-49withatleastonepartnerwhowas:•Preventative/prophylactictreatedwithin14daysoftest(amongsyphilistestedabovewithnegativetestandrecentexposure)*.•Treatedasanewcaseofsyphiliswithin30daysbeforeorafterspecimencollectionoftheoriginalpatient*.7/1/16-6/30/19CXIH.Forcongenitalsyphiliscases:Contactprovidertoassureneededclinicalevaluation,casereporting,andcorrecttreatment.Involvesubjectmatterexperts,asneeded.(Requiredactivity).Proportionwithappropriatecasemanagementdocumentation(e.g.,congenitalsyphiliscasereport)anddocumentedtreatment,whereappropriate*.7/1/16-6/30/19Proportionofconfirmedandprobablecongenitalsyphiliscaseswhereneonatewas•Appropriatelymedicallyevaluatedwithin14days•Appropriatelytreatedwithin14days*1X3I.Conductfollow-upforsuspecteddrug-resistantGCcases:Knownorsuspectedtreatmentfailuresand/ordecreasedsusceptibilitytotreatment(i.e.,highMIC).(Requiredactivity).Numberandproportionofcaseswithsuspectedtreatmentfailuresthatwereinterviewed.NumberandproportionofcaseswithhighMICsthatwereinterviewedandbroughttocarefortest-of-cure.7/1/16-6/30/19Page12of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables*=CDPH'//illprovidebiannualreportsv/ithindicatorTimelineIIJ.ConductfollowupforselectedGCcases:Personswithincreasedriskoftransmission(e.g.,repeatcases,HIV-infectedcases)and/orpregnantfemales.ProportionofGCcasesthatareretestedin3months.NumberandproportionofGCcaseswithdocumentedGCtestingand/orappropriatetreatmentforatleastonepartner.ProportionofinitiatedpartnersofGC/HIVco-infectedcasesthatare:•NewlytestedforHIV•NewlyidentifiedHIVpositive•ConfirmedlinkagetoHIVcarewithin90daysofHIV-positivetest*7/1/16-6/30/19||K.Conductfollow-upforselectedGCcases:Personslocatedingeo-targetedareaswithconcentratedmorbidity.NumberandproportionofGCcasesinterviewedfromgeo-targetedlocations.NumberandproportionofGCcaseswithatleastonepartnerwastestedand/ortreatedappropriatelyforGC.7/1/16-6/30/19[XIL.ConductdiseaseinvestigationforclustersoroutbreaksoflesscommonDescriptionofactivitieswillbeincludedintheEndof7/1/16-6/30/19STDs,suchaschancroidorlymphogranulomavenereum(LGV).(Requiredactivity).YearReport.asneededReportdueannuallyby7/31Page13of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables"=CDPHwillprovidebiannualreportswithindicatorTimelineLX]M.EnsuredataentryinCalREDIEtoreflectdiseaseinterventionandpartnerservicesactivitiesforsyphilis,GC,andotherSTDsdeterminedapriorityforpublichealthaction.1.Enterclientleveldemographic,laboratory,clinical,andcaseinvestigationactivitiesonrelevantCalREDIEsystemstabs.2.Enterclientinterviewrecordswithenhancedsurveillancedata,includingsyphilisinterviewrecordandCGSSproviderreportandpatientinterviewforms.3.Entercongenitalsyphiliscasereportforms,accordingtoguidanceandalgorithm.4.Entersexualandsocialnetworkpartnerinformationandinvestigation/notificationoutcomes.(Requiredactivity).Completionandclosureofcasereportforms,interviewrecords,andpartnerinvestigationoutcomesinCalREDIE*.7/1/16-6/30/19OngoingdataentryCaseclosuresasdescribedinI.B.Optional:PlaceacheckmarkintheboxonlyifGranteeplanstosubcontract.IIN.Subcontractwithcommunity-basedorotherorganizationstoensuresuccessofcoreSTDprogramfunctions(checkboxifconductingthisactivity).Subcontractwithcommunityorotherorganizations,ifneeded.7/1/16-6/30/19OptionalSOWNarrative:LHJhasneworinnovativetasksthatarenotDartofcurrentPartIVactivities.DescribethespecificmethodsandapDroachesthatwillbeusedtocompletetheactivitiesselectedforthisobjective.Brieflydescribetheanticipatedscopeoftheproposedactivities,deliverables,andaprojectedtimeline,includingtheapproximatebeginningandendingmonthandyearforeachmajoractivity.Notapplicable.Page14of16 ExhibitAScopeofWorkCountyofFresno16-10713ActivitiesPerformanceIndicators/Deliverables*=CDPHwillprovidebiannualreportswithindicatorTimelineV.AssurethatlocalSTDpoliciesandcommunicationsareeffective.IXlA.Promotethepresence,relevancy,andaccuracyofwebpage(s)onhealthdepartmentwebsitewithdata,linkstoproviderresources,andsexualandreproductivehealtheducationmaterials.(Requiredactivity).Presenceonwebsite,socialmedia,etc.7/1/16-6/30/19IXlB.Identifyandrespondtoopportunitiestoeducatecommunitypartners,policymakers,andthemedia.(Requiredactivity).DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31IXC.Participateinrelevantcommunitycoalitionsfocusedonsexualhealth.(Requiredactivity).DescriptionofactivitieswillbeincludedintheEnd-of-Yearreport.7/1/16-6/30/19Reportdueannuallyby7/31Optional:PlaceacheckmarkintheboxonlyifGranteeplanstosubcontract.IID.Subcontractwithcommunity-basedorotherorganizationstoensuresuccessofcoreSTDprogramfunctions(checkboxifconductingthisactivity).Subcontractwithcommunityorotherorganizations,ifneeded.7/1/16-6/30/19OptionalSOWNarrative:LHJhasneworinnovativetasksthatarenotpartofcurrentPartVactivities.Describethespecificmethodsandapproachesthatwillbeusedtocompletetheactivitiesselectedforthisobjective.Brieflydescribetheanticipatedscopeoftheproposedactivities,deliverables,andaprojectedtimeline,includingtheapproximatebeginningandendingmonthandyearforeachmajoractivity.Notapplicable.TheGranteemayusefundstoprintorduplicateposters,brochures,pamphlets,andothermaterialstopromoteSTDawareness,testing,andtreatmentofat-riskpopulations.Page15of16 ExhibitAScopeofWorkCountyofFresno16-107136.SummaryofRequiredReportsandDataFrequencyTimeFrameDeadlineProgramReportRecipientOnce7/01/16-6/30/196/30/19CoreSTDProgramManagementSTDLHJContracts{5)cdDh.ca.qovBiannual7/1/16-12/31/162/28/17STDCaseClosureCalREDIEdatasystem1/1/17-6/30/178/31/177/1/17-12/31/172/28/181/1/18-6/30/188/31/187/1/18-12/31/182/28/191/1/19-6/30/196/30/19Page16of16 CountyofFresno16-10713Page1of2ExhibitBBudgetDetailandPaymentProvisions1.InvoicingandPaymentA.UponcompletionofprojectactivitiesasprovidedinExhibitA,ScopeofWork,anduponreceiptandapprovaloftheinvoices,theStateagreestoreimbursetheGranteeforactivitiesperformedandexpendituresincurredinaccordancewiththecostsspecifiedherein.B.Invoicesshallincludethegrantnumberandshallbesubmittedinduplicatenotmorefrequentlythanquarterlyinarrearsto:ChristineJohnsonCaliforniaDepartmentofPublicHealthSTDControlBranchMS7320P.O.Box997377Sacramento,CA95899-7377C.Invoicesshall:1)Bepreparedusingthenewlyimplementedandrequiredelectronicinvoiceprocessandtemplate,whichwillbeprovidedbyyourCDPHGrantManager.2)InvoicesmustbesubmittedtoCDPHelectronicallyonly.Hardcopiesarenotrequired.3)Identifythebillingand/orperformanceperiodcoveredbytheinvoice.4)Itemizecostsforthebillingperiodinthesameorgreaterlevelofdetailasindicatedinthisagreement.Subjecttothetermsofthisagreement,reimbursementmayonlybesoughtforthosecostsand/orcostcategoriesexpresslyidentifiedasallowableinthisagreementandapprovedbyCDPH.2.BudgetContingencyClauseA.ItismutuallyagreedthatiftheBudgetActofthecurrentyearand/oranysubsequentyearscoveredunderthisagreementdoesnotappropriatesufficientfundsfortheprogram,thisagreementshallbeofnofurtherforceandeffect.Inthisevent,theStateshallhavenoliabilitytopayanyfundswhatsoevertoGranteeortofurnishanyotherconsiderationsunderthisagreementandGranteeshallnotbeobligatedtofulfillanyprovisionsofthisagreement.B.IffundingforanyfiscalyearisreducedordeletedbytheBudgetActforpurposesofthisprogram,theStateshallhavetheoptiontoeithercancelthisagreementwithnoliabilityoccurringtotheState,orofferanagreementamendmenttotheGranteetoreflectthereducedamount. CountyofFresno16-10713Page2of2ExhibitBBudgetDetailandPaymentProvisions3.PromptPaymentClausePaymentwillbemadeinaccordancewith,andwithinthetimespecifiedin,GovernmentCodeChapter4.5,commencingwithSection927.4.TimelySubmissionofFinalInvoiceA.Afinalundisputedinvoiceshallbesubmittedforpaymentnomorethansixty(60)calendardaysfollowingtheexpirationorterminationdateofthisgrant,unlessalateroralternatedeadlineisagreedtoinwritingbytheprogramGrantManager.Saidinvoiceshouldbeclearlymarked"FinalInvoice,"indicatingthatallpaymentobligationsoftheStateunderthisgranthaveceasedandthatnofurtherpaymentsaredueoroutstanding.B.TheStatemay,atitsdiscretion,choosenottohonoranydelinquentfinalinvoiceiftheGranteefailstoobtainpriorwrittenStateapprovalofanalternatefinalinvoicesubmissiondeadline.5.TravelandPerDiemReimbursementAnyreimbursementfornecessarytravelandperdiemshallbeattheratescurrentlyineffectasestablishedbytheCaliforniaDepartmentofHumanResources(CalHR).6.UseofFunds/SupplantingThesefundsshallbeusedtosupplementandenhanceexistinglocalSTDprogramactivitiesandservicesandshallnotreplaceexistingservicesandactivities,preventtheadditionofnewservicesandactivities,anddoesnotduplicatereimbursementofcostsandservicesreceivedfromlocalfundsorothersources. CountyofFresno16-10713Page1of4ExhibitCStandardGrantConditions1.APPROVAL:ThisgrantisofnoforceoreffectuntilsignedbybothpartiesandapprovedbytheDepartmentofGeneralServices,ifrequired.TheGranteemaynotcommenceperformanceuntilsuchapprovalhasbeenobtained.2.AMENDMENT:Noamendmentorvariationofthetermsofthisgrantshallbevalidunlessmadeinwriting,signedbytheparties,andapprovedasrequired.Nooralunderstandingoragreementnotincorporatedinthegrantisbindingonanyoftheparties.InnocaseshalltheDepartmentmateriallyalterthescopeoftheprojectsetforthinExhibitA.3.ASSIGNMENT:ThisgrantisnotassignablebytheGrantee,eitherinwholeorinpart,withoutthewrittenconsentoftheGrantManagerintheformofawrittenamendmenttothegrant.4.AUDIT:GranteeagreesthattheDepartment,theBureauofStateAudits,ortheirdesignatedrepresentativeshallhavetherighttoreviewandtocopyanyrecordsandsupportingdocumentationpertainingtothisgrant.Granteeagreestomaintainsuchrecordsforapossibleauditforaminimumofthree(3)yearsafterfinalpaymentorcompletionoftheprojectfundedwiththisgrant,unlessalongerperiodofrecordsretentionisstipulated.Granteeagreestoallowtheauditor(s)accesstosuchrecordsduringnormalbusinesshoursandtoallowinterviewsofanyemployeeswhomightreasonablyhaveinformationrelatedtosuchrecords.Further,GranteeagreestoincludeasimilarrightoftheStatetoauditrecordsandinterviewstaffinanysubcontractrelatedtotheproject.5.CONFLICTOFINTEREST:Granteecertifiesthatitisincompliancewithallapplicablestateand/orfederalconflictofinterestlaws.6.INDEMNIFICATION:Granteeagreestoindemnify,defend,andsaveharmlesstheState,itsofficers,agents,andemployeesfromanyandallclaimsandlossesaccruingorresultingtoanyandallcontractors,subcontractors,suppliers,laborers,andanyotherperson,firm,orcorporationfurnishingorsupplyingworkservices,materials,orsuppliesinconnectionwiththeproject,andfromanyandallclaimsandlossesaccruingorresultingtoanyperson,firm,orcorporationwhomaybeinjuredordamagedbyGranteeintheperformanceofanyactivitiesrelatedtotheproject.7.FISCALMANAGEMENTSYSTEMSANDACCOUNTINGSTANDARDS:Granteeagreesthat,ataminimum,itsfiscalcontrolandaccountingprocedureswillbesufficienttopermittracingofallgrantfundstoalevelofexpenditureadequatetoestablishthatsuchfundshavenotbeenusedinviolationofanyapplicablestateorfederallaw,ortheprovisionsofthisgrant.Granteefurtheragreesthatitwillmaintainseparateprojectaccountsinaccordancewithgenerallyacceptedaccountingprinciples.8.GOVERNINGLAW:ThisgrantisgovernedbyandshallbeinterpretedinaccordancewiththelawsoftheStateofCalifornia. CountyofFresno16-10713Page2of4ExhibitCStandardGrantConditions9.INCOMERESTRICTIONS:Granteeagreesthatanyrefunds,rebates,credits,orotheramounts(includinganyinterestthereon)accruingtoorreceivedbytheGranteeunderthisgrantshallbepaidbytheGranteetotheDepartment,totheextentthattheyareproperlyallocabletocostsforwhichtheGranteehasbeenreimbursedbytheDepartmentunderthisgrant.10.INDEPENDENTGRANTEE:Grantee,anditsagentsandemployeesofGrantee,intheperformanceoftheproject,shallactinanindependentcapacityandnotasofficers,employees,oragentsoftheDepartment.11.MEDIAEVENTS:GranteeshallnotifytheDepartment'sGrantManagerinwritingatleasttwenty(20)workingdaysbeforeanypublicormediaeventpublicizingtheaccomplishmentsand/orresultsoftheprojectandprovidetheopportunityforattendanceandparticipationbyDepartment'srepresentatives.12.NOTHIRD-PARTYRIGHTS:TheDepartmentandGranteedonotintendtocreateanyrightsorremediesforanythird-partyasabeneficiaryofthisgrantortheproject.13.NOTICE:GranteeshallpromptlynotifytheDepartment'sGrantManagerinwritingofanyevents,developments,orchangesthatcouldaffectthecompletionoftheprojectorthebudgetapprovedforthisgrant.14.PROFESSIONALS:Granteeagreesthatonlylicensedprofessionalswillbeusedtoperformservicesunderthisgrantwheresuchservicesarecalledfor.15.RECORDS:Granteecertifiesthatitwillmaintainprojectaccountsinaccordancewithgenerallyacceptedaccountingprinciples.GranteefurthercertifiesthatitwillcomplywiththefollowingconditionsforagrantawardassetforthintheRequestforApplications(ExhibitD)andtheGrantApplication(ExhibitA).A.Establishanofficialfilefortheprojectwhichshalladequatelydocumentallsignificantactionsrelativetotheproject;B.Establishseparateaccountswhichwilladequatelyandaccuratelydepictallamountsreceivedandexpendedonthisproject,includingallgrantfundsreceivedunderthisgrant;C.Establishseparateaccountswhichwilladequatelydepictallincomereceivedwhichisattributabletotheproject,especiallyincludinganyincomeattributabletograntfundsdisbursedunderthisgrant;D.Establishanaccountingsystemwhichwilladequatelydepictfinaltotalcostsoftheproject,includingbothdirectandindirectcosts;andE.Establishsuchaccountsandmaintainsuchrecordsasmaybenecessaryforthestatetofulfillfederalreportingrequirements,includinganyandallreportingrequirementsunderfederaltaxstatutesorregulations. CountyofFresno16-10713Page3of4ExhibitCStandardGrantConditions16.RELATEDLITIGATION:UndernocircumstancesmayGranteeusefundsfromanydisbursementunderthisgranttopayforcostsassociatedwithanylitigationbetweentheGranteeandtheDepartment.17.RIGHTSINDATA:GranteeandtheDepartmentagreethatalldata,plans,drawings,specifications,reports,computerprograms,operatingmanuals,notes,andotherwrittenorgraphicworksubmittedunderExhibitAintheperformanceoftheprojectfundedbythisgrantshallbeinthepublicdomain.Granteemaydisclose,disseminate,anduse,inwholeorinpart,anyfinalform,data,andinformationreceived,collected,anddevelopedunderthisproject,subjecttoappropriateacknowledgmentofcredittotheDepartmentforfinancialsupport.GranteeshallnotutilizethematerialssubmittedtotheDepartment(exceptdata)foranyprofit-makingventureorsellorgrantrightstoathird-partywhointendstodoso.TheDepartmenthastherighttousesubmitteddataforallgovernmentalpurposes.18.VENUE:TheDepartmentandGranteeagreethatanyactionarisingoutofthisgrantshallbefiledandmaintainedintheSuperiorCourt,California.Granteewaivesanyexistingsovereignimmunityforthepurposesofthisgrant,ifapplicable.19.STATE-FUNDEDRESEARCHGRANTSA.Granteeshallprovideforfreepublicaccesstoanypublicationofadepartment-fundedinventionordepartment-fundedtechnology.GranteefurtheragreestoalltermsandconditionsrequiredbytheCaliforniaTaxpayerAccesstoPubliclyFundedResearchAct(Chapter2.5(commencingwithSection13989)ofPart4.5ofDivision3ofTitle2oftheGovernmentCode).B.Asaconditionofreceivingtheresearchgrant,GranteeagreestothefollowingtermsandconditionswhicharesetforthinGovernmentCodeSection13989.6.1)GranteeisresponsibleforensuringthatanypublishingorcopyrightagreementsconcerningsubmittedmanuscriptsfullycomplywithSection13989.6.2)GranteesshallreporttotheDepartmentthefinaldispositionoftheresearchgrant,including,butnotlimitedto,ifitwaspublished,whenitwaspublished,whereitwaspublished,whenthe12-monthtimeperiodexpires,andwherethemanuscriptwillbeavailableforopenaccess.3)Foramanuscriptthatisacceptedforpublicationinapeer-reviewedjournal,theGranteeshallensurethatanelectronicversionofthepeer-reviewedmanuscriptisavailabletothedepartmentanonanappropriatepubliclyaccessibledatabaseapprovedbytheDepartment,including,butnotlimitedto,theUniversityofCalifornia'seScholoarshipRepositoryattheCaliforniaDigitalLibrary,tobemadepubliclyavailablenotlaterthan12monthsaftertheofficialdateofpublication.ManuscriptssubmittedtotheCaliforniaDigitalOpenSourceLibraryshallbeexemptfromthe CountyofFresno16-10713Page4of4ExhibitCStandardGrantConditionsrequirementsinsubdivision(b)ofSection66408oftheEducationCode.Granteeshallmakereasonableeffortstocomplywiththisrequirementbyensuringthattheirmanuscriptisaccessibleonanapprovedpubliclyaccessibledatabase,andnotifyingtheDepartmentthatthemanuscriptisavailableonadepartment-approveddatabase.IfGranteeisunabletoensurethattheirmanuscriptisaccessibleonanapprovedpubliclyaccessibledatabase,GranteemaycomplybyprovidingthemanuscripttotheDepartmentnotlaterthan12monthsaftertheofficialdateofpublication.4)ForpublicationsotherthanthosedescribedinparagraphB.3above,includingmeetingabstracts,GranteeshallcomplybyprovidingthemanuscripttotheDepartmentnotlaterthan12monthsaftertheofficialdateofpublication.5)Granteeisauthorizedtousegrantmoneyforpublicationcosts,includingfeeschargedbyapublisherforcolorandpagecharges,orfeesfordigitaldistribution. CountyofFresno16-10713Page1of3ExhibitDAdditionalProvisions1.Cancellation/TerminationA.ThisgrantmaybecancelledbyCDPHwithoutcauseuponthirty(30)calendardaysadvancewrittennoticetotheGrantee.B.CDPHreservestherighttocancelorterminatethisgrantimmediatelyforcause.TheGranteemaysubmitawrittenrequesttoterminatethisgrantonlyifCDPHsubstantiallyfailstoperformitsresponsibilitiesasprovidedherein.C.Theterm“forcause”shallmeanthattheGranteefailstomeettheterms,conditions,and/orresponsibilitiesofthisagreement.Causesforterminationinclude,butarenotlimitedto,thefollowingoccurrences:1)IftheGranteeknowinglyfurnishesanystatement,representation,warranty,orcertificationinconnectionwiththeagreement,whichrepresentationismateriallyfalse,deceptive,incorrect,orincomplete.2)IftheGranteefailstoperformanymaterialrequirementofthisgrantordefaultsinperformanceofthisagreement.3)IftheGranteefilesforbankruptcy,orifCDPHdeterminesthattheGranteebecomesfinanciallyincapableofcompletingthisagreement.D.GrantterminationorcancellationshallbeeffectiveasofthedateindicatedinCDPH’snotificationtotheGrantee.Thenoticeshallstipulateanyfinalperformance,invoicing,orpaymentrequirements.E.Intheeventofearlyterminationorcancellation,theGranteeshallbeentitledtocompensationforservicesperformedsatisfactorilyunderthisagreementandexpensesincurreduptothedateofcancellationandanynon-cancelableobligationsincurredinsupportofthisgrant.F.Intheeventoftermination,andattherequestofCDPH,theGranteeshallfurnishallproposals,specifications,designs,procedures,layouts,copy,andothermaterialsrelatedtotheservicesordeliverablesprovidedunderthisgrant,whetherfinishedorinprogressontheterminationdate.G.TheGranteewillnotbeentitledtoreimbursementforanyexpensesincurredforservicesanddeliverablespursuanttothisagreementaftertheeffectivedateoftermination. CountyofFresno16-10713Page2of3ExhibitDAdditionalProvisionsH.Uponreceiptofnotificationofterminationofthisgrant,andexceptasotherwisespecifiedbyCDPH,theGranteeshall:1)Placenofurtherorderorsubgrantsformaterials,services,orfacilities.2)Settlealloutstandingliabilitiesandallclaimsarisingoutofsuchterminationofordersandsubgrants.3)UpontheeffectivedateofterminationofthegrantandthepaymentbyCDPHofallitemsproperlychargeabletoCDPHhereunder,Granteeshalltransfer,assign,andmakeavailabletoCDPHallpropertyandmaterialsbelongingtoCDPH,allrightsandclaimstoanyandallreservations,grants,andarrangementswithownersofmedia/PRmaterials,orothers,andshallmakeavailabletoCDPHallwritteninformationregardingCDPH'smedia/PRmaterials,andnoextracompensationistobepaidtoGranteeforitsservices.4)Takesuchactionasmaybenecessary,orasCDPHmayspecify,toprotectandpreserveanypropertyrelatedtothisagreementwhichisinthepossessionoftheGranteeandinwhichCDPHhasormayacquireaninterest.I.CDPHmay,atitsdiscretion,requiretheGranteetoceaseperformanceofcertaincomponentsoftheScopeofWorkasdesignatedbyCDPHandcompleteperformanceofothercomponentspriortotheterminationdateofthegrant.2.AvoidanceofConflictsofInterestbyGranteeA.CDPHintendstoavoidanyrealorapparentconflictofinterestonthepartoftheGrantee,subgrants,oremployees,officers,anddirectorsoftheGranteeorsubgrants.Thus,CDPHreservestherighttodetermine,atitssolediscretion,whetheranyinformation,assertion,orclaimreceivedfromanysourceindicatestheexistenceofarealorapparentconflictofinterest;and,ifaconflictisfoundtoexist,torequiretheGranteetosubmitadditionalinformationoraplanforresolvingtheconflict,subjecttoCDPHreviewandpriorapproval.B.Conflictsofinterestinclude,butarenotlimitedto:1)AninstancewheretheGranteeoranyofitssubgrants,oranyemployee,officer,ordirectoroftheGranteeoranysubgranthasaninterest,financialorotherwise,wherebytheuseordisclosureofinformationobtainedwhileperformingservicesunderthegrantwouldallowforprivateorpersonalbenefitorforanypurposethatiscontrarytothegoalsandobjectivesofthegrant. CountyofFresno16-10713Page3of3ExhibitDAdditionalProvisions2)AninstancewheretheGrantee’soranysubgrant’semployees,officers,ordirectorsusetheirpositionsforpurposesthatare,orgivetheappearanceofbeing,motivatedbyadesireforprivategainforthemselvesorothers,suchasthosewithwhomtheyhavefamily,businessorotherties.C.IfCDPHisorbecomesawareofaknownorsuspectedconflictofinterest,theGranteewillbegivenanopportunitytosubmitadditionalinformationortoresolvetheconflict.AGranteewithasuspectedconflictofinterestwillhavefive(5)workingdaysfromthedateofnotificationoftheconflictbyCDPHtoprovidecompleteinformationregardingthesuspectedconflict.IfaconflictofinterestisdeterminedtoexistbyCDPHandcannotberesolvedtothesatisfactionofCDPH,theconflictwillbegroundsforterminatingthegrant.CDPHmay,atitsdiscretionuponreceiptofawrittenrequestfromtheGrantee,authorizeanextensionofthetimelineindicatedherein.